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Percutaneous Transhepatic Biliary
Drainage ( PTBD )


What is PTBD ?

A Percutaneous Transhepatic Biliary Drainage (PTBD )is a percutaneous therapeutic procedure . It leads to the drainage of the obstructed bile duct system. If endoscopy is not possible and if the patient is inoperable, then the percutaneous access is indicated for the treatment of jaundice.


Used In Conditions Like

  • pre-operative procedure for resectable malignancies, prior to neoadjuvant chemotherapy or as a palliative technique.
  • malignancy of the bile ducts.
  • malignancy of the pancreas head.
  • malignancy of the adjacent organs or structures, like lymphnodes, the gallbladder or the stomach.
  • high biliary obstructions.
  • failed endoscopic drainage
  • Post-operative cases with biliary obstruction.
  • biliary stones
  • strictures after surgery

Role Of Interventional Radiology

Biliary drainage, can be palliative in inoperable patients or pre-operative to improve liver function prior to surgery

The key purpose of biliary intervention:

  • Decompression of the obstructed biliary system.
  • Developing a communication between the biliary tree and the bowel allowing physiological bile flow.
  • Decreasing pain, jaundice and occurrence of cholangitis by relieving the obstruction.

The drainage of the bile ducts is performed with a small plastic catheter. The catheter is placed internally across the narrowed duct, having an external end connected to a drainage bag. The catheter is secured to the skin with sutures. The drainage procedure can be extended with the placement of a permanent metallic device, called stent, which keeps the biliary ducts open without any need for a catheter. It is a safe,effective and well tolerated procedure.